摘要
目的 建立脊髓横断损伤后神经源性膀胱(NB)大鼠模型,应用超声观察膀胱形态学变化,分析其与尿流动力学指标的相关性.方法 将27只SPF级SD大鼠按照随机数表法分为空白对照组8只、假手术组8只和模型组11只,其中空白对照组正常饲养;假手术组暴露脊髓后依次缝合并予抗感染处理;模型组采用手术建立脊髓横断损伤后NB大鼠模型.观察各组大鼠活动、食量、水量、排尿、排便和死亡等情况;建模后第19天大鼠排尿后于呼吸麻醉状态下应用超声测量膀胱上下径、左右径、前后径及膀胱壁厚度,计算膀胱容积;检测大鼠尿流动力学指标,包括大鼠膀胱最大压力、膀胱最大容量、灌注时间和漏尿点压力,比较各组大鼠上述指标的差异.然后处死大鼠并摘取膀胱逼尿肌组织进行病理组织学检查.采用Pearson相关分析法分析各组大鼠膀胱超声指标与尿流动力学指标的相关性.结果 模型组有3只大鼠造模失败,8只造模成功.①一般情况:与空白对照组和假手术组比较,模型组大鼠食量减少,体质量下降,毛色光泽度偏暗,活动量减少;假手术组与空白对照组大鼠一般情况基本一致.②超声指标:与空白对照组和假手术组比较,模型组膀胱上下径、左右径、前后径及膀胱壁厚度均增加,膀胱容积增大,差异均有统计学意义(均P<0.05).③尿流动力学指标:与空白对照组和假手术组比较,模型组大鼠膀胱最大压力升高,膀胱最大容量增加,灌注时间延长,漏尿点压力升高,差异均有统计学意义(均P<0.05).④病理组织学结果:空白对照组和假手术组大鼠膀胱组织基本正常,模型组膀胱组织中移行上皮细胞排列紊乱,细胞固有膜结构疏松破坏,可见组织水肿及出血性改变,肌纤维排列紊乱,伴局部纤维结缔组织增生.⑤相关性分析显示,各组大鼠膀胱壁厚度与膀胱最大压力、膀胱最大容量、灌注时间、漏尿点压力均呈线性相关(均P<0.05).结论 本实验成功建立脊髓横断损伤后NB大鼠模型,超声检查发现NB大鼠膀胱壁厚度增加,且其与尿流动力学指标均呈线性相关,提示超声可用于评估NB大鼠膀胱功能.
Abstract
Objective To establish the neurogenic bladder(NB)rats model after spinal cord transection injury,to observe the morphological changes of the bladder by ultrasonography,and to analyze the correlation between the morphological changes and urodynamic indexes.Methods Twenty-seven SPF-grade SD rats were divided into blank control group(n=8),sham-operation group(n=8),and model group(n=11)according to the random number table.The blank control group was raised normally.The sham-operation group was sequentially sutured and given anti-infective treatment after the spinal cord exposed.In the model group,the NB rat model after spinal cord transection was established by operation.The activities,food intake,water intake,urination,defecation,and death of rats in each group were observed.On the 19th day after operation,the left and right diameters,anterior and posterior diameters,upper and lower diameters and the thickness of bladder were measured by ultrasound under respiratory anesthesia of rats in each group,and the bladder volume was calculated.The urodynamic indexes of rats were detected,including the maximum bladder pressure,maximum bladder volume,perfusion time and leakage point pressure.The differences of the above indexes in each group were compared.Then the rats were sacrificed and the bladder detrusor tissues were removed for histopathological examination.Pearson correlation analysis was used to analyze the correlation between bladder ultrasound indexes and urodynamic indexes.Results Three rats in the model group failed to establish the model,and 8 rats succeeded in the establishment of the model.①General condition:compared with the blank control group and the sham-operation group,the rats in the model group had less food intake,lower body weight,darker coat color gloss,and less activities.The general conditions of the sham-operation group and the blank control group were basically the same.②Ultrasound indexes:compared with the blank control group and the sham-operation group,the bladder wall thickness,upper and lower diameter,left and right diameter,and anterior and posterior diameter of the model group were all increased,and the bladder volume was increased,and the differences were statistically significant(all P<0.05).③Urodynamic indexes:compared with the blank control group and the sham-operation group,the maximum bladder pressure,maximum bladder volume,perfusion time and leakage point pressure of the model group were increased,and the differences were statistically significant(all P<0.05).④Histopathological results:the bladder tissues of rats in the blank control group and the sham-operation group were basically normal.In the model group,the transitional epithelial cells in the bladder tissues were disordered,the structure of the cell intrinsic membrane was loosed and damaged,tissue edema and hemorrhagic changes were found,muscle fibers were disordered,and local fibrous connective tissue hyperplasia was observed.⑤Correlation analysis showed that the bladder wall thickness of rats in each group was linearly correlated with maximum bladder pressure,the maximum bladder volume,perfusion time,and leakage point pressure(all P<0.05).Conclusion The NB rat model after spinal cord transection injury is successfully established in this experiment,and ultrasound examination showed that the bladder wall thickness of NB rats increased,and it is in a linear correlation with urodynamic dynamics indexes.It is suggested that ultrasound is expected to be a method for evaluating the bladder function in NB rats.
基金项目
国家自然科学基金面上项目(82274666)
国家自然科学基金面上项目(81874510)
湖南中医药大学学科建设"揭榜挂帅"项目(22JBZ013)
NETL
NSTL
维普
万方数据